Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018

Background and purpose — Periprosthetic joint infection (PJI) is a devastating complication and more information on risk factors for PJI is required to find measures to prevent infections. Therefore, we assessed risk factors for PJI after primary total hip arthroplasty (THA) in a large patient cohor...

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Autores principales:	Valtteri J Panula, Kasperi J Alakylä, Mikko S Venäläinen, Jaason J Haapakoski, Antti P Eskelinen, Mikko J Manninen, Jukka S Kettunen, Ari-Pekka Puhto, Anna I Vasara, Laura L Elo, Keijo T Mäkelä
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2021
Materias:	Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/dc1ea6492e58403ab8393fbda594a9f7
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spelling	oai:doaj.org-article:dc1ea6492e58403ab8393fbda594a9f72021-11-26T11:19:48ZRisk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 20181745-36741745-368210.1080/17453674.2021.1944529https://doaj.org/article/dc1ea6492e58403ab8393fbda594a9f72021-10-01T00:00:00Zhttp://dx.doi.org/10.1080/17453674.2021.1944529https://doaj.org/toc/1745-3674https://doaj.org/toc/1745-3682Background and purpose — Periprosthetic joint infection (PJI) is a devastating complication and more information on risk factors for PJI is required to find measures to prevent infections. Therefore, we assessed risk factors for PJI after primary total hip arthroplasty (THA) in a large patient cohort. Patients and methods — We analyzed 33,337 primary THAs performed between May 2014 and January 2018 based on the Finnish Arthroplasty Register (FAR). Cox proportional hazards regression was used to estimate hazard ratios with 95% confidence intervals (CI) for first PJI revision operation using 25 potential patient- and surgical-related risk factors as covariates. Results — 350 primary THAs were revised for the first time due to PJI during the study period. The hazard ratios for PJI revision in multivariable analysis were 2.0 (CI 1.3–3.2) for ASA class II and 3.2 (2.0–5.1) for ASA class III–IV compared with ASA class I, 1.4 (1.1–1.7) for bleeding > 500 mL compared with < 500 mL, 0.4 (0.2–0.7) for ceramic-on-ceramic bearing couple compared with metal-on-polyethylene and for the first 3 postoperative weeks, 3.0 (1.6–5.6) for operation time of > 120 minutes compared with 45–59 minutes, and 2.6 (1.4–4.9) for simultaneous bilateral operation. In the univariable analysis, hazard ratios for PJI revision were 2.3 (1.7–3.3) for BMI of 31–35 and 5.0 (3.5–7.1) for BMI of > 35 compared with patients with BMI of 21–25. Interpretation — We found several modifiable risk factors associated with increased PJI revision risk after THA to which special attention should be paid preoperatively. In particular, high BMI may be an even more prominent risk factor for PJI than previously assessed.Valtteri J PanulaKasperi J AlakyläMikko S VenäläinenJaason J HaapakoskiAntti P EskelinenMikko J ManninenJukka S KettunenAri-Pekka PuhtoAnna I VasaraLaura L EloKeijo T MäkeläTaylor & Francis GrouparticleOrthopedic surgeryRD701-811ENActa Orthopaedica, Vol 92, Iss 6, Pp 665-672 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Orthopedic surgery RD701-811
spellingShingle	Orthopedic surgery RD701-811 Valtteri J Panula Kasperi J Alakylä Mikko S Venäläinen Jaason J Haapakoski Antti P Eskelinen Mikko J Manninen Jukka S Kettunen Ari-Pekka Puhto Anna I Vasara Laura L Elo Keijo T Mäkelä Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018
description	Background and purpose — Periprosthetic joint infection (PJI) is a devastating complication and more information on risk factors for PJI is required to find measures to prevent infections. Therefore, we assessed risk factors for PJI after primary total hip arthroplasty (THA) in a large patient cohort. Patients and methods — We analyzed 33,337 primary THAs performed between May 2014 and January 2018 based on the Finnish Arthroplasty Register (FAR). Cox proportional hazards regression was used to estimate hazard ratios with 95% confidence intervals (CI) for first PJI revision operation using 25 potential patient- and surgical-related risk factors as covariates. Results — 350 primary THAs were revised for the first time due to PJI during the study period. The hazard ratios for PJI revision in multivariable analysis were 2.0 (CI 1.3–3.2) for ASA class II and 3.2 (2.0–5.1) for ASA class III–IV compared with ASA class I, 1.4 (1.1–1.7) for bleeding > 500 mL compared with < 500 mL, 0.4 (0.2–0.7) for ceramic-on-ceramic bearing couple compared with metal-on-polyethylene and for the first 3 postoperative weeks, 3.0 (1.6–5.6) for operation time of > 120 minutes compared with 45–59 minutes, and 2.6 (1.4–4.9) for simultaneous bilateral operation. In the univariable analysis, hazard ratios for PJI revision were 2.3 (1.7–3.3) for BMI of 31–35 and 5.0 (3.5–7.1) for BMI of > 35 compared with patients with BMI of 21–25. Interpretation — We found several modifiable risk factors associated with increased PJI revision risk after THA to which special attention should be paid preoperatively. In particular, high BMI may be an even more prominent risk factor for PJI than previously assessed.
format	article
author	Valtteri J Panula Kasperi J Alakylä Mikko S Venäläinen Jaason J Haapakoski Antti P Eskelinen Mikko J Manninen Jukka S Kettunen Ari-Pekka Puhto Anna I Vasara Laura L Elo Keijo T Mäkelä
author_facet	Valtteri J Panula Kasperi J Alakylä Mikko S Venäläinen Jaason J Haapakoski Antti P Eskelinen Mikko J Manninen Jukka S Kettunen Ari-Pekka Puhto Anna I Vasara Laura L Elo Keijo T Mäkelä
author_sort	Valtteri J Panula
title	Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018
title_short	Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018
title_full	Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018
title_fullStr	Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018
title_full_unstemmed	Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018
title_sort	risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the finnish arthroplasty register from 2014 to 2018
publisher	Taylor & Francis Group
publishDate	2021
url	https://doaj.org/article/dc1ea6492e58403ab8393fbda594a9f7
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Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018

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